Dilan Shah, DMD

Individual provider Active NPI General Practice Dentistry · Johnsburg, IL

NPI 1033008362 · NPPES record last updated Jul 1, 2025

Key facts

NPI
1033008362
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
019.036214 (IL)
Practice address
4113 N Johnsburg Rd
Johnsburg, IL 60051-6323
Phone
(815) 344-0028
NPI assigned
Jul 1, 2025
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
019.036214ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Johnsburg Dental Center General Practice Past
since Jul 9, 2025
Accepting new patients
Edp of Illinois P.C Single Specialty Past
since Jul 9, 2025
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X 019.036214 IL Yes

Addresses

Primary practice location

4113 N Johnsburg Rd
Johnsburg, IL 60051-6323

Mailing address

1340 Saint Claire PL
Schaumburg, IL 60173-6186
Phone (847) 347-7789

Other providers in Johnsburg, IL

All providers in Johnsburg, IL · General Practice Dentistry in Illinois

Sources for this page

Verify at the official NPI Registry.